Individual provider Active NPI

Adrianne Andersen, OTD OTR/L

  • Pediatric Occupational Therapist
  • Layton, UT
National Provider Identifier
1679747547
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
4996708-4201 Issued in UT
Practice address
1010 N Emerald Dr
Layton, UT 84040-8260
Phone
(801) 402-5403
NPI assigned
Apr 22, 2008
Last updated
Aug 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 4996708-4201 UT
Pediatric Occupational Therapist 225XP0200X 4996708-4201 UT Primary

Addresses

Primary practice location

1010 N Emerald Dr
Layton, UT 84040-8260

Mailing address

1010 N Emerald Dr
Layton, UT 84040-8260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4996708-4201UTMDPediatric Occupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1679747547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N EMERALD DR",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840408260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N EMERALD DR",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840408260",
            "telephone_number": "801-402-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "ADRIANNE",
        "credential": "OTD OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "4996708-4201",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "UT",
            "license": "4996708-4201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.